Organization
HEMATOLOGY-ONCOLOGY ASSOCIATES OF NORTH JERSEY LLC
Active
Other names
Dr. Mohtaseb's Cancer Center And Blood Disorders
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HAMDY A MOHTASEB MD, FACP (PRESIDENT/MEMBER)
(928) 219-4560
Entity
Organization
Contact information
Practice address
3003 HIGHWAY 95 STE G73, BULLHEAD CITY, AZ 86442-7860
(928) 219-4560
(928) 219-4561
Mailing address
3003 HIGHWAY 95 STE G73, BULLHEAD CITY, AZ 86442-7860
(928) 219-4560
(928) 219-4561
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
6441700001
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
044000
MEDICARE ID TYPE UNSPECIF
—
05
—
6670901
—
NJ
01
—
MA61425
NJ LICENSE
NJ
Enumeration date
04/02/2008
Last updated
12/20/2024
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